Maxillary Reconstruction in Cleft Lip and Palate Patients: Clinical Case Series

Aim: To evaluate the effects of maxillary distraction osteogenesis in patients with cleft lip and palate. Material and Methods: Three patients being treated at the Institute of Orthodontics and Maxillo-Facial department (Coimbra Hospital and Universitary Centre), were submitted to osteogenic distraction. The technique was performed before secondary bone grafting surgery, due to wide cleft, with an internal distractor. Clinical control was done and recorded with intra-oral photographs before and after the procedure. Results: In cases of wide orofacial cleft palates, dehiscence in the bone graft may occur. Distraction osteogenesis is a safe method that reduces the size of large cleft palate, which improves the predictability of alveolar secondary bone graft surgery, as it allows transportation of alveolar bone towards the defect. In all cases, bone formation for orthodontic movement was verified, which allowed maxillary reconstruction. Conclusion: Wide cleft palates can be successfully treated using internal distraction osteogenesis. This protocol improves the predictability of alveolar secondary bone graft surgery.